THE ROLE OF LIFESTYLES IN ETHNIC DIFFERENCES IN COGNITIVE IMPAIRMENT AMONG ADULTS AGED 50 YEARS OR OLDER

Abstract Background We examined ethnic differences in the prevalence of cognitive impairment and explored the impact of lifestyles on disparities in cognitive function among adults aged 50 years or above in Western China. Methods 6,840 participants aged 50 years or older from the West China Health and Aging Trend Study (WCHAT) were included. Cognitive impairment was identified by the Short Portable Mental Status Questionnaire (SPMSQ). We used logistic regression to examine the association between ethnicity (seven groups) and cognitive impairment and the contribution of lifestyle factors to ethnic disparities. Results The prevalence of cognitive impairment ranged from 6.2% in Bai to 29.3% in Yi. After multivariable adjustment, Tibetan had the highest odds of cognitive Impairment (OR=3.22, 95% CI 2.55-4.08), followed by Yi (OR=2.76, 95% CI: 2.121-3.59), Uighur (OR=2.59, 95% CI: 1.86-3.61) and Qiang (OR=2.10, 95% CI: 1.67-2.65), compared to Han. Lifestyle factors explained 22.2% of the ethnic difference in cognitive impairment. Conclusions The prevalence of cognitive impairment varied widely across ethnic groups. Interventions promoting healthy lifestyles might help reduce the ethnic disparities in cognitive function among Chinese older adults.

analyzed data from 117 cognitively normal participants (44 men and 73 women) aged 60 and older (M = 74.82,SD = 6.52) to compare the effects of objectively measured sleep on executive function.Total sleep time was recorded with the GT9X Link Actigraph worn for seven consecutive days.The composite score of executive function was derived from a confirmatory factor analysis consisting of four separate tests (Verbal Fluency, Trail Making Test Part B, Digit Symbol Substitution Test, and Stroop Interference).We used hierarchical multiple regression to investigate sex differences in the effects of total sleep time on executive function.A quadratic model of total sleep time was a significant predictor of executive function in women (β = -.251,p = .034),but not in men adjusting for age and education.Longer sleep duration predicted improved executive function, but the performance decreased with oversleeping.These findings imply that interventions aimed at optimizing sleep duration may be beneficial for executive function in older women.Further research is necessary to identify sex-specific sleep requirements, which can inform the development of personalized interventions for older adults.

THE COGNITION IN PRIMARY CARE PROGRAM: A STEP-BY-STEP CLINIC WORKFLOW PUTTING THE GSA KAER TOOLKIT INTO ACTION
Jaqueline Raetz 1 , Annette Fitzpatrick 1 , Basia Belza 1 , Sarah McKiddy 1 , Amy Hsu 1 , Joshua Liao 1 , Christina Park 2 , and Barak Gaster 1 , 1. University of Washington, Seattle, Washington, United States, 2. University of Washington, Seattle, Seattle, Washington, United States In 2020 University of Washington (UW) Medicine began developing Cognition in Primary Care (CPC), a quality improvement program adapting the GSA KAER Toolkit to help primary care providers (PCPs) detect patients with cognitive impairment in their 16-clinic primary care network.The CPC consists of a 3-part training program to help PCPs diagnose, manage and counsel patients; a set of tools embedded into the electronic health record to facilitate cognitive evaluation; and an in-clinic workflow providing on-site support for providers within their own clinic setting.During this process we interviewed providers and developed a hybrid remote and in-person orientation for clinics to initiate a workflow to support improved cognitive evaluations.Utilizing pre-implementation input, the CPC in-clinic workflow was pilot-tested at two UW primary care clinics in 2021/2022.This presentation will describe content of the clinic orientation and implementation of CPC to include 1) the typical timeframe and content of orientation; 2) meetings with clinic leadership; 3) overview of provider/ staff meetings; 4) in-person walk-through for placement of materials; 5) invitation to training; 6) a 12-page handbook outlining steps in the workflow; 7) other printed CPC materials, e.g., dementia warning signs, MoCA and AD8 forms, Alzheimer Association referral cards; and 8) follow-up focus group feedback.Evaluation of the pilot clinics following implementation found significant use of all tools by PCPs and an increase in diagnoses of mild cognitive impairment.This clinic workflow may be useful as a model for other health care systems to initiate cognitive evaluation programs in primary care.The present study aimed to examine the association between oral health and cognitive function among older adults in India.Data for the study were selected from the Longitudinal Aging Survey of India (LASI, 2017(LASI, -2019) ) and the LASI Diagnostic Assessment of Dementia (LASI-DAD) and 4,096 respondents aged 60 and above were included.Oral health was measured by self-reported physiciandiagnosed oral health problems including presence of painful teeth, ulcers for more than two weeks, bleeding gums, swelling gums, loose teeth, dental cavities or caries, soreness or cracks in the corners of the mouth, or other problems as well as edentulism (i.e., losing all natural teeth, some natural teeth, or no teeth).A higher number of these problems indicated a more complex oral health condition.Cognitive function was measured by the standardized total score of all cognitive tests in the Harmonized Cognitive Assessment Protocol (HCAP).Binomial logistic regression models were used to analyze the relationship between the diagnosis of oral health problems and cognitive function.Results showed that having one or more oral health problems was associated with lower scores on cognitive function (β=-0.16,p=0.04), after controlling for sociodemographic characteristics and health status.There was no significant association between edentulism and cognitive function.Findings of the study suggest that oral health is integral to long-term overall health, specifically cognitive function.Our findings highlight the importance of educating older individuals about the connection between oral health and cognitive function along with the need for broadening their access to oral health care in India.
Abstract citation ID: igad104.2958Chengdu, Sichuan, China (People's Republic) Background: We examined ethnic differences in the prevalence of cognitive impairment and explored the impact of lifestyles on disparities in cognitive function among adults aged 50 years or above in Western China.Methods: 6,840 participants aged 50 years or older from the West China Health and Aging Trend Study (WCHAT) were included.Cognitive impairment was identified by the Short Portable Mental Status Questionnaire (SPMSQ).We used logistic regression to examine the association between ethnicity (seven groups) and cognitive impairment and the contribution of lifestyle factors to ethnic disparities.Results: The preva-

ACUTE CARE USE FOR OLDER ADULTS WITH DIABETES AND DEMENTIA IN A PRAGMATIC CLINICAL TRIAL OF PANEL MANAGEMENT
Brianna Morgan 1 , Mauricio Arcila-Mesa 2 , Crystalinda Rapozo 1 , Oluwaseun Adeyemi 3 , and Joshua Chodosh 1 , 1. NYU Grossman School of Medicine, New York City, New York, United States, 2. NYU Langone, New York City, New York, United States, 3. New York University Grossman School of Medicine, New York City, New York, United States Individuals with diabetes mellitus and Alzheimer's disease and related disorders (DM-ADRD) face greater self-management challenges, over and under treatment, and more acute care episodes.Enhanced Quality in Primary Care for Elders with Diabetes-ADRD (EQUIPED-ADRD) is a pragmatic randomized controlled trial providing practice guidelines alone (control) compared to practice guidelines plus panel management (intervention) in primary care.Panel management includes patient self-management support and enhanced engagement and support for staff.Thirty-one primary care practices were randomized (14 control versus 17 intervention clinics).We assessed differences in emergency department (ED) use and hospitalizations in individuals with DM-ADRD comparing groups using univariate analysis.Included patients receiving care at randomized clinics were >65 years old, had DM, ADRD, an identified caregiver, and available utilization data.We tracked ED use and hospitalizations over 24 months using electronic health records.Panel management dose was number of phone calls.Among those having utilization data, 177 received panel management versus 349 who did not (total n=526).Patients were predominantly 75-84 years old (41.3%), female (59.9%), and non-Hispanic white (50.9%); 25.9% were Hispanic and 10.7% were non-Hispanic Black.52.0% (n=92) panel managed patients had ED visits versus 41.8% (n=146) not panel managed [(p=0.027Implementing person-centred, cost-effective, and comprehensive self-management programs for older adults with multimorbidity and their caregivers in the health and social care system is challenging.Innovations that are effective under controlled research conditions often fail to produce similar results when implemented in real world settings to reach larger populations of older adults.Scalability assessment is a promising methodology to reduce this researchpractice gap.This study aims to examine the scalability of a self-management intervention for older adults with diabetes and multimorbidity and their caregivers in two Canadian provinces.Provincial working groups, including patient partners, participated in the scalability assessment.The Intervention Scalability Assessment Tool (ISAT) guided

THE RELATIONSHIP BETWEEN ORAL HEALTH AND COGNITIVE FUNCTION: EVIDENCE FROM THE LASI
Xi Pan 1 , Uma Kelekar 2 , and T Muhammad 3 , 1.Texas State University, San Marcos, Texas, United States, 2.